Abstract A retrospective evaluation was undertaken on the frequency of presentations of DKA and HHS to emergency departments to three major hospitals. Biochemical results, glucose and bicarbonate specifically, and pH, when available, were used to classify patients into DKA or HHS and determine the prevalence based on sex and age, using five different age groups (0-19; 20-39; 40-59; 60-79, ≥ 80). The results showed 1,913 (0.92% of 207,665) patients who presented to the EDs had glucose > 14.0 mmol/L of which 261 (13.64%) were classified as either DKA (n = 199, 76.24%) or HHS (n = 62, 23.7%). There was greater prevalence amongst males for both conditions; for DKA the ratio was 1.4:1 M:F and for HHS the ratio was 1.6:1 M:F. The age group with greatest prevalence for both was 40-59 years, and the DKA:HHS ratio for each age group was 0-19 years 5.4:1; 20-39 years 3.3:1; 40-59 years 2.4:1; 60-79 years 3.0:1; 4 and 80+ years 4.3:1. Overall DKA was 3.3 times more prevalent than HHS in the patients presenting to EDs in these three hospitals; however HHS presents at a younger age group than commonly described due to the incidence of T2DM presenting at younger age.
Keywords: diabetes; prevalence; diabetic ketoacidosis; DKA; hyperglycaemic hyperosmolar syndrome; HHS; emergency department